歯学ジャーナル
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概要

Prevalence of Antibiotic Resistance in Conjunctival Bacterial Microbiota and Associated Risk Factors among Indian Patients Undergoing Cataract Surgery

Meena Lakshmipathy*, Manokamna Agarwal, Viswanathan N, Anand A.R

Purpose: To report conjunctival bacterial micro biome with antibiotic sensitivity patterns and associated factors from eyes of patients undergoing cataract surgery.

Methods: Retrospective observational study was done on clinical and microbiological data of adult monocular patients, who underwent cataract surgery between January 2010 and June 2017 in their seeing eye. Conjunctival swabs taken (3742 eyes) with positive bacterial culture on conjunctival swab in a tertiary care eye hospital. Data was retrieved from electronic database and logistic regression analysis was performed to identify the likelihood of resistance to drugs and associated factors.

Results: Of 1150 eyes studied in this period of 91 months period, commonest bacteria isolated were gram positive cocci (n=881, 76.6%), gram positive bacilli (n=153, 13.3%), gram negative bacilli (n=112, 9.7%), and gram negative cocci (n=4, 0.3%).

Among gram positive cocci, Staphylococcus epidermidis (n=660, 57.39%) was most common bacterium isolated from conjunctival swabs. Gram positive cocci showed highest sensitivity to vancomycin (>99%), and highest resistance to penicillin (65%), norfloxacin (30%), ofloxacin (22%) and ciprofloxacin (21%). Resistance to methicillin increased the likelihood of multi drug resistance (OR=3.8, 95%CI=1.2-11.8, p=0.02). In case of gram negative bacilli, all 112 isolates were sensitive to amikacin (100%), and were resistant to fluoroquinolones, moxifloxacin (14% each), and ciprofloxacin and norfloxacin (11% each).

Conclusion: Staphylococcus epidermidis was the commonest commensal of conjunctival flora, in this large cohort from all over India. The relatively high resistance to fluroquinolone antibiotics and methicillin urges periodic studies monitoring antibiotic sensitivity pattern of conjunctival flora in the wake of indiscriminate and rampant use of antibiotics for prophylaxis.